CHRONIC KIDNEY DISEASE IS ASSOCIATED WITH MILD COGNITIVE IMPAIRMENT AND ALZHEIMER'S DISEASE IN OLDER MEXICAN PEOPLE

Abstract

In elderly patients with cognitive problems, few studies looked at the association between renal function and cognitive function, and there is a need for confirmation studies to evaluate this association. This could help clinicians to screen for renal dysfunction in elderly patients with cognitive problems. Objective: to investigate the association between renal function and cognitive function in patients who presented Mild Cognitive Impairment (MCI) and Alzheimer Disease (AD). Cross-sectional study. We included 298 subjects of a memory clinic Mexico City. 60 (20%) with a normal cognitive assessment, 66 (22%) with MCI and 172 (58%) with AD. Medical record, cognitive, depression and functionality assessments were collected and reviewed by a geriatric and neurology physicians. We calculated the eGFR using: Modification of Diet in Renal Disease (MDRD) and Haematocrit, blood Urea GEnder (HUGE) equation. HUGE not use serum creatinine. Mean and SD (estándar deviation) of continuous variable were compared using analysis of variance for characteristics according to eGFR category, and cognitive status. Categorical variables were compared using chi square test. Then we used binary logistic regression to assess the association between eGFR category and cognitive status. 131 women (55%), Mean Age 80.87 (7.34), mean eGFR 1.027 mL/min/1.73m2, Low eGFR measure by HUGE equation, and not by MDRD, was statistical significant in the AD group. The multivariate regression analysis showed that patient with a HUGE equation abnormal (value > 0) was associated with AD, adjusting for age, and gender (Model 1) OR 5.38, (95% CI 1.23-23.53 p =0.01), adjusting for age, gender and smoking (Model 2) OR = 4.66, (95% CI 1.04-20.82 p= 0.01), and adjusting by the above and MMSE, clock test, functionality, and Geriatric Depression Scale (Model 3) OR= 5.83 (95% CI 1.07-31.64 p =0.01). A low eGFR determined by the formula HUGH (and not with the MDRD), was associated with an increased risk of cognitive impairment, independent of other vascular risk factors. Also, HUGE is useful to measure kidney function and determine the association between cognitive and renal function in elderly.